Healthcare Provider Details

I. General information

NPI: 1124561014
Provider Name (Legal Business Name): RACHEL FLORES LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2016
Last Update Date: 11/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 LAKE BLVD
OCEANSIDE CA
92056-4731
US

IV. Provider business mailing address

4110 LAKE BLVD
OCEANSIDE CA
92056-4731
US

V. Phone/Fax

Practice location:
  • Phone: 760-637-4661
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: